Outbursts Of Anger Research Articles

Normative Irritability in Youth: Developmental Findings From the Great Smoky Mountains Study

The goal of this study is to examine the developmental epidemiology of normative irritability and its tonic and phasic components in a longitudinal community sample of youth. Eight waves of data from the prospective, community Great Smoky Mountains Study (6,674 assessments of 1,420 participants) were used, covering children in the community 9 to 16 years of age. Youth and 1 parent were interviewed using the Child and Adolescent Psychiatric Assessment to assess tonic (touchy/easily annoyed, irritable mood, angry or resentful) and phasic (temper tantrums or anger outbursts) components of irritability, including frequency, duration, onset, and cross-context variability. At any given point in childhood/adolescence, 51.4% (standard error [SE]= 1.4) of participants reported phasic irritability, 28.3% (SE= 1.2) reported tonic irritability, and 22.8% (SE= 1.1) reported both. These prevalence levels decreased with age but did not vary by sex. The overlap between tonic and phasic irritability was high (odds ratio= 5.8, 95% CI= 3.3-10.5, p<.0001), with little evidence of tonic occurring without phasic irritability. Both tonic and phasic irritability predicted one another over time, supporting both heterotypic and homotypic continuity. Low levels of either tonic or phasic irritability increased risk for disrupted functioning including service use, school suspensions, parental burden, and emotional symptoms both concurrently and at 1-year follow-up. Irritability is relatively common, decreases with age but does not vary by sex, and at almost any level is associated with increased risk of disrupted functioning. Its relative components frequently overlap, although irritable outbursts are more common than irritable mood. Irritability appears to be a high-priority transdiagnostic marker for screening children in need of clinical attention.

Circus maximus: the economic gamble behind hosting the Olympics and the World Cup

The numbers are staggering: China spent $40 billion to host the 2008 Summer Olympic Games in Beijing and Russia spent $50 billion for the 2014 Sochi Winter Games. Brazil's total expenditures are thought to have been as much as $20 billion for the World Cup this summer and Qatar, which will be the site of the 2022 World Cup, is estimating that it will spend $200 billion. How did we get here? And is it worth it? Those are among the questions noted sports economist Andrew Zimbalist answers in Circus Maximus: The Economic Gamble Behind Hosting the Olympics and the World Cup . Both the Olympics and the World Cup are touted as major economic boons for the countries that host them, and the competition is fierce to win hosting rights. Developing countries especially see the events as a chance to stand in the world's spotlight. Circus Maximus traces the path of the Olympic Games and the World Cup from noble sporting events to exhibits of excess. It exposes the hollowness of the claims made by their private industry boosters and government supporters, all illustrated through a series of case studies ripping open the experiences of Barcelona, Sochi, Rio, and London. Zimbalist finds no net economic gains for the countries that have played host to the Olympics or the World Cup. While the wealthy may profit, those in the middle and lower income brackets do not, and Zimbalist predicts more outbursts of political anger like that seen in Brazil surrounding the 2014 World Cup.

Trauma-focused cognitive behaviour therapy versus treatment as usual for post traumatic stress disorder (PTSD) in young children aged 3 to 8 years: study protocol for a randomised controlled trial.

BackgroundFollowing horrific or life-threatening events approximately 10 to 15% of young children develop post traumatic stress disorder (PTSD). The symptoms of this disorder are distressing - nightmares, flashbacks, anger outbursts and disturbed play. These symptoms cause major disruption to a child’s functioning and, if left untreated, can persist for many years. As yet, there are no established empirically-validated treatments for PTSD in young children. Trauma-focused cognitive behaviour therapy (TF-CBT) is a psychological intervention that is effective in treating the disorder in older children (8 to 12 years), adolescents and adults. This study examines TF-CBT adapted for children aged between 3 and 8 years.Methods/DesignThis protocol describes a two-arm exploratory randomised controlled trial comparing TF-CBT to treatment as usual (TAU) in children aged 3 to 8 years with a principal diagnosis of PTSD following a single-event discrete trauma. Using a half-crossover design, 44 participants will be randomly allocated to receive the intervention or to receive TAU. Those allocated to TAU will be offered TF-CBT at the end of the ‘treatment’ period (approximately 12 weeks) if still indicated. The primary outcome is PTSD diagnosis according to DSM-5 criteria for children 6 years and younger at post-treatment. Secondary outcomes include effects on co-morbid diagnoses and changes in emotion and trauma symptoms at each of the follow-up points (post-treatment, 3-months, 12-months). Additionally, broader efficacy will be considered with regard to treatment feasibility, acceptability and service utilisation. The key targets of the intervention are trauma memory, the interpretation of the meaning of the event, and the management of symptoms.DiscussionThis is the first European trial to examine the efficacy of TF-CBT in alleviating PTSD in very young children. As well as providing much-needed data on the utility of the intervention, this exploratory trial will also allow us to gather important information about the feasibility of delivering the treatment in UK National Health Service (NHS) settings, and its acceptability to the children and their families. This study will highlight aspects of the intervention that need improvement or modification in preparation for a full-scale evaluation in a larger sample.Trial registrationISRCTN35018680, registered on 18 November 2013.

Characteristics of young offenders depending on the type of crime

The aim of this study is to define a profile of juvenile offenders depending on the type of crime (against property or against persons), according to several socio-demographic variables, and a number of indicators of juvenile risk. Participants were 395 adolescents between the ages of 14 and 18 with a criminal record in the juvenile court over a two-year follow-up period. Results showed that in property-related offences the offender is more likely to be male, from an Eastern European country, and with inconsistent parenting. On the other hand, crimes against persons would be committed mostly by girls, Latin American or African juveniles, and with individual factors such as aggressive behaviour, outbursts of anger, poor frustration tolerance, or little concern for others. These results may be useful in designing crime prevention and offender intervention programmes.

Le trouble bipolaire chez l’enfant et l’adolescent : un diagnostic difficile

Bipolar disorder (BD) is a severe mental condition with neurodevelopmental features that clinically results in pathological fluctuations of mood. Whereas it was classically or traditionally considered as an adult-onset disorder, recent findings suggest that BD may occur very early in the life course, thus, determining what is now called Juvenile bipolar disorder (JBD). One of the reasons for which JBD has been so difficult to identify is that JBD primary symptoms vary much from the typical adulthood BD clinical expression. Euphoric mood is rare in JBD, while irritability mood, aggressive temper, mixed manic state onset, rapid cycling, anger outbursts and chronic course of symptoms are much more frequent. This specific clinical presentation makes JBD difficult to differentiate from other diagnoses related to pathological externalizing behaviours, including conduct disorder, oppositional provocative disorder, and attention deficit-hyperactivity disorder.

Pharmacological treatment of Tourette syndrome

Tourette syndrome (TS) is a highly heritable yet heterogeneous childhood onset disorder. The cardinal movement disorder required for diagnosis is tics. As persons with tics or TS often have obsessive/compulsiveness, inattention, hyperactivity, impulsivity, anxiety, and anger outbursts, the presence of tics should prompt clinicians to look for these other conditions. While randomized controlled trials provide valid evidence of efficacy for symptoms in isolation, implications for treatment of complex patients meeting criteria for multiple diagnoses is not always clear. In this review, the authors critically review factors influencing decisions whether and how to treat medically tics as well as OCD and ADHD in the presence of tics.

Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample.

Individuals with misophonia display extreme sensitivities to selective sounds, often resulting in negative emotions and subsequent maladaptive behaviors, such as avoidance and anger outbursts. While there has been increasing interest in misophonia, few data have been published to date. This study investigated the incidence, phenomenology, correlates, and impairment associated with misophonia symptoms in 483 undergraduate students through self-report measures. Misophonia was a relatively common phenomenon, with nearly 20% of the sample reporting clinically significant misophonia symptoms. Furthermore, misophonia symptoms demonstrated strong associations with measures of impairment and general sensory sensitivities, and moderate associations with obsessive-compulsive, anxiety, and depressive symptoms. Anxiety mediated the relationship between misophonia and anger outbursts. This investigation contributes to a better understanding of misophonia and indicates potential factors that may co-occur and influence the clinical presentation of a person with misophonia symptoms.

Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis

Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis

Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis

Short-term psychological stress is associated with an immediate physiological response and may be associated with a transiently higher risk of cardiovascular events. The aim of this study was to determine whether brief episodes of anger trigger the onset of acute myocardial infarction (MI), acute coronary syndromes (ACS), ischaemic and haemorrhagic stroke, and ventricular arrhythmia. We performed a systematic review of studies evaluating whether outbursts of anger are associated with the short-term risk of heart attacks, strokes, and disturbances in cardiac rhythm that occur in everyday life. We performed a literature search of the CINAHL, Embase, PubMed, and PsycINFO databases from January 1966 to June 2013 and reviewed the reference lists of retrieved articles and included meeting abstracts and unpublished results from experts in the field. Incidence rate ratios and 95% confidence intervals were calculated with inverse-variance-weighted random-effect models. The systematic review included nine independent case-crossover studies of anger outbursts and MI/ACS (four studies), ischaemic stroke (two studies), ruptured intracranial aneurysm (one study), and ventricular arrhythmia (two studies). There was evidence of substantial heterogeneity between the studies (I(2) = 92.5% for MI/ACS and 89.8% for ischaemic stroke). Despite the heterogeneity, all studies found that, compared with other times, there was a higher rate of cardiovascular events in the 2h following outbursts of anger. There is a higher risk of cardiovascular events shortly after outbursts of anger.

The hostile heart: anger as a trigger for acute cardiovascular events

This editorial refers to ‘Outbursts of anger as a trigger of acute cardiovascular events: a systematic review andmeta-analysis’, by E. Mostofsky et al. , doi:10.1093/eurheartj/ehu033. The link between anger and adverse cardiovascular events is well ingrained in both patients' and clinicians' minds. Mediated through increases in circulating catecholamines, increased myocardial oxygen demand, coronary vasospasm, and increased platelet aggregability, anger can cause transient ischaemia, disruption of vulnerable plaques, and increased thrombotic potential. These changes can then result in myocardial or cerebral ischaemia or malignant arrhythmias.1 Multiple studies have shown that acute mental stress (in a laboratory setting) can provoke ischaemia of similar or greater severity and extent to exercise in 40–70% of patients with coronary artery disease,2,3 and this ischaemia increases the long-term risk of fatal and non-fatal cardiac events.4,5 In addition, T-wave alternans induced by mental stress in a laboratory has been shown to predict future ventricular arrhythmias in patients with implantable defibrillators.6 While the long-term link between chronic mental stress, anxiety, depression, and hostility with adverse cardiovascular events has been well established, it has been more difficult to determine the short-term risk of an acute outburst of anger. Ideally, understanding this risk would require large, prospective epidemiological studies that track outbursts of anger and …

CVS to phase out tobacco sales, launch smoking cessation program

Calling the decision "simply the right thing to do for the good of our customers and our company," CVS Caremark will stop selling all tobacco products at its more than 7,600 CVS/pharmacy locations by October 1. The February 5 announcement came a week after the U.S. Surgeon General issued renewed warnings about tobacco use on the 50th anniversary of the Surgeon General's landmark report linking smoking and poor health.

Externalizing and Internalizing Subtypes of Posttraumatic Psychopathology and Anger Expression

Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory-2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben-Porath, ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss-Durkee Hostility Inventory, [BDHI]; Buss & Durkee, ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of "irritability and anger outbursts" were found across scales in the total sample (range: r = .19-.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.

Association of Family Structure and its Environment with Aggressive Behaviour of Children (6-8years) in a Rural Community

Objectives: To determine the association of family structure and family environment with aggressive behavior of children (6-8years) in a rural community of Gadap town, Karachi, Pakistan Subjects and Methods: This is a questionnaire based cross sectional survey to determine the association of family structure and environment with aggressive behavior of children (6-8years). Aggressive behaviour is defined as sudden, explosive outbursts of anger and has been reported as a clinical problem in approximately 23% -40% of children in some communities. The information was collected by interviewing parents regarding their family structure, family environment and aggressive behavior of children in school and at home. This quantitative assessment was made on a validated Performa. The data was analyzed on SPSS windows version 16. Results: Total numbers of respondents were 384. The impact of aggressive behavior in children were anger 32.8%, violence 36.5%, lack of tolerance for minor disputes 32.3%, respectively. The reliability statistics table had the actual value for Cronbach’s alpha at 89.1%. The association of aggressive behavior in children has been rooted in the family size in 34.4%, family type 27.6%, family environment 23.7% and intimate partner violence in 30.2%. Conclusion: One third of school children had aggressive behaviour directly related to family size and family environment in a rural area. The significant major risk factors were age, family size 34.4%, family type 27.6%, family environment 23.7% and intimate partner violence in 30.2%.

Association of Family Structure and its Environment with Aggressive Behaviour of Children (6-8years) in a Rural Community

Objectives: To determine the association of family structure and family environment with aggressive behavior of children (6-8years) in a rural community of Gadap town, Karachi, Pakistan Subjects and Methods: This is a questionnaire based cross sectional survey to determine the association of family structure and environment with aggressive behavior of children (6-8years). Aggressive behaviour is defined as sudden, explosive outbursts of anger and has been reported as a clinical problem in approximately 23% -40% of children in some communities. The information was collected by interviewing parents regarding their family structure, family environment and aggressive behavior of children in school and at home. This quantitative assessment was made on a validated Performa. The data was analyzed on SPSS windows version 16. Results: Total numbers of respondents were 384. The impact of aggressive behavior in children were anger 32.8%, violence 36.5%, lack of tolerance for minor disputes 32.3%, respectively. The reliability statistics table had the actual value for Cronbach’s alpha at 89.1%. The association of aggressive behavior in children has been rooted in the family size in 34.4%, family type 27.6%, family environment 23.7% and intimate partner violence in 30.2%. Conclusion: One third of school children had aggressive behaviour directly related to family size and family environment in a rural area. The significant major risk factors were age, family size 34.4%, family type 27.6%, family environment 23.7% and intimate partner violence in 30.2%.

Tardive dyskinesia in a pregnant woman with low dose, short-duration risperidone: possible role of estrogen-induced dopaminergic hypersensitivity

Tardive dyskinesia in a pregnant woman with low dose, short-duration risperidone: possible role of estrogen-induced dopaminergic hypersensitivity

Depression is More Than Just Sadness: A Case of Excessive Anger and Its Management in Depression

People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT) is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression.

Veterans’ Mental Health: Challenges and Issues of College Enrolled OIF and OEF Veterans

To help mental health professionals and college personnel better understand the mental health needs of returning veterans from the Iraq and Afghanistan wars, 39 veterans enrolled at a comprehensive State University completed questionnaires that surveyed their symptoms related to posttraumatic stress disorder (PTSD) and Depression. Irritability, outbursts of anger, feeling detached or estranged from others were the most frequently reported symptoms of PTSD. Depressed mood most of the day and sleep disorders were the most reported symptoms of depression. Five percent reported taking psychiatric medication and 31% had seen a counselor. Twenty-one percent met the criteria to receive a formal diagnosis of PTSD and 27% met criteria for Major Depression.

Low-Dose Quetiapine for the Treatment of Delusional Disorder in a Patient With Von Hippel-Lindau Disease

Low-Dose Quetiapine for the Treatment of Delusional Disorder in a Patient With Von Hippel-Lindau Disease

The ‘Arab Uprising’, Islamists and Democratization

This article surveys political activities of selected Islamists in three Arab countries in the Mediterranean region: Tunisia, Egypt and Morocco. Each is notable for recent growth in Islamist political activity in the context of democratization (Tunisia, Egypt) and political liberalization (Morocco). Tunisia, Egypt and Morocco are undergoing political changes consequent to the recent ‘Arab uprising’. The ‘Arab uprising’ involved country-specific yet variable outbursts of popular political anger, although not necessarily with a clear and consistent democratizing focus. Generally, protests focused on interrelated political and socio-economic demands, including: greater ‘freedoms’, improved human rights, better social justice and economic progress, especially more jobs for millions of unemployed youths. The aim of the article is to explain recent developments in relation to the ‘Arab uprising’ in three Mediterranean Arab countries – Tunisia, Egypt and Morocco. The purpose is to complement the individual foci on these countries in subsequent papers in this special issue by providing a thematic overview and to locate the activities of Islamist entities in Tunisia, Egypt and Morocco in comparative context.

The Effects of Combined Omega-3 Fatty Acids and Valproic Acid Supplementation on Symptoms of Borderline Personality Disorder: A Pilot Study

In recent years, omega-3 fatty acids have received increasing interest for their stabilizing effects on plasmatic membranes and cell signalling. Recent studies have considered the efficacy of these agents in treatment of several psychiatric disorders, in particular mood disorders. Two recent trials have tested the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in patients with borderline personality disorder (BPD). The present pilot study is testing safety of administering EPA and DHA in association with valproic acid and efficacy of EPA and DHA plus valproic acid in reducing symptoms of BPD. A group of 10 BPD patients treated for 12 weeks was evaluated at baseline and after 12 weeks with: CGI – Severity Item, HAM-D, HAM-A, SOFAS, BPDSI for BPD related symptoms, BIS-11 for impulsivity, MOAS for aggressiveness, SHI for self-injuries, and DOTES for adverse effects. The association had significant effects on the complex of BPD related symptoms (p=0.010), depression (p=0.028), affective instability (p=0.001), impulsive behaviors (p=0.001), and outbursts of anger (p=0.008). Adverse effects were mild to moderate dyspepsia, nausea, and weight gain. These initial data suggest that combined therapy with omega-3 fatty acids and valproate is an effective and well tolerated option in the treatment of BPD. Actual contribution of EPA and DHA to the overall effects of the association need to be assessed in a controlled study.